Mortality inequality in 1-59 months children across Iranian provinces: referring system and determinants of death based on hospital records

To determine inequality in mortality in 1-59 months children across Iranian provinces focusing on referring system and determinants of death. After designing and examining a national questionnaire for mortality data collection of children 1-59 months, 40 medical universities have been asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009. Mortality in 1-59 months children was unequally distributed across provinces [universities]. The recommended refer was 3466 but only 1620 patients were referred. The first five important determinants of death were congenital [671 children or 20.9%], accident [547 children or 17.1%], pulmonary diseases [370 children or 11.5%], cardiovascular [266 children or less than 8.3%], central nervous system [263 children or 8.2%], and infectious and parasitic diseases [245 children or 7.6%], respectively. Our results suggest that inequality in 1-59 months mortality based on the hospital records, and specially referring system, needs more attention in Iran. In addition, it is advisable to conduct provincially representative surveys to provide recent estimates of hospital access inequalities and to allow monitoring over time

Distribution of mortality among 1 - 59 month-old children across Iranian provinces in 2009: the national mortality surveillance system

To determine the distribution of mortality in 1 - 59 month-old children across Iranian provinces in a national mortality surveillance system. This national survey was conducted in 2009. A questionnaire was designed and standardized for collecting mortality data of children aged 1 - 59 months. The project team, consisting of collaborators from the whole 40 medical universities, filled in the questionnaires and returned them to the Ministry of Health and Medical Education [MOHME]. The mortality in 1 - 59 month-old children was unequally distributed across provinces. The mortality was higher among children of less- educated mothers than in children of more- educated mothers. There was a reverse association between 1 - 59 months mortality and socioeconomic status across Iran as a whole and within most provinces. Our results suggest that socioeconomic distribution in mortality of 1 - 59 month-old children favors the better-off in Iran as a whole and in most of its provinces. Investigating why mortality is higher in some provinces deserves special attention. Furthermore, it is advisable to conduct provincially-representative surveys to provide update estimates of different health situations and to allow their monitoring over time